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COVID-19 response in southern Nigeria boosts surveillance of other diseases

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In many countries, tackling the COVID-19 pandemic has taken cues from other disease approaches, such as lessons from protecting communities against Ebola. But in Nigeria’s Niger Delta, health workers have found inspiration from guarding against the coronavirus.

They have exploited the rigorous surveillance standard set by the COVID-19 response to keep from losing sight of other priority diseases. Mostly what they have learned is how not to divide their attention.

The unifying surveillance strategy they have enveloped is quickly producing significant and – possibly oddly – uplifting results.

“I recorded my first acute flaccid paralysis case since last year while I was following up on the contact of a confirmed case of COVID-19,” says Sarah Oladimeji, a Diseases and Surveillance Notification Officer in charge of finding cases of preventable and infectious diseases in Oredo Local Government Area of Nigeria’s Edo State.

When COVID-19 crept into the southern Delta region in April, health workers had to learn to overcome their worries and hunkered down to the needed work. The odds seemed stacked against the six states that make up the South-South zone: Akwa Ibom, Bayelsa, Cross River, Delta, Edo and Rivers. COVID-19 cases increased daily while community attitudes towards the virus grew lax. Health workers scrambled to manage the time and resources available to respond to both COVID-19 and other endemic-prone diseases.

One solution government teams and health workers hit upon: bring the aggressive COVID-19 surveillance into the systems used to monitor priority diseases.

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Across the Niger Delta, the World Health Organization (WHO) and its partners retrained 3874 surveillance officers who had been mobilized to detect COVID-19 cases in hospitals and communities to also look for acute flaccid paralysis (AFP), polio, meningitis, cholera, neonatal tetanus, yellow fever, measles and more.

After the Government decentralized the COVID-19 response in April, some states began also training religious and community leaders – who are often important decision-makers, influencers and informants – to help find and report suspected COVID-19 and other priority diseases in their communities.

Now, four months into the region’s COVID-19 outbreak, health workers are seeing spectacular efficiency. Detected cases of AFP, for example, increased substantially (doubling and even tripling in one state) between the end of March and end of July as the harmonized surveillance ramped up.

Protecting immunization gains

Keeping eyes on both COVID-19 and other diseases, most of which are vaccine-preventable, is an important but challenging task in the Niger Delta where immunization coverage had been low for years. Located along the Niger River and the Gulf of Guinea, the Niger Delta, or South-South zone, comprises a system of coastal communities that rely on farming and fishing. Waterway systems here are often inadequate and moving around is difficult. In the past, residents in the deepest riverine communities, far from a mainland, had little luck accessing a health centre. Many were discouraged by the distance from taking their children for vaccinations, which led the region to its poor immunization coverage and thus heightened risk of disease outbreaks.

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Since 2016, community engagement, better access to health care and increased surveillance have led to rising numbers of vaccinated children. Health workers now attend patients in on-sea treatment centres or travel into the deep-river communities by canoe to provide services.

Navigating the creek communities may be hard but health workers accept that medical care has no boundaries, says Dr Edmund Ogbe, WHO Coordinator for Bayelsa State. Public health commitment and resourcefulness seem to be ingrained characteristics of this region.

Increased detection of measles and yellow fever

To protect their gains in immunization coverage and keep from neglecting other worrisome diseases in these times of COVID-19, the integrated surveillance is making a difference. In March, Bayelsa State recorded nine cases of AFP. But 16 new cases were investigated over the next four months – a 180% increase.

With COVID-19 case findings now meshed with the systems used to detect and report priority diseases, more cases of measles and yellow fever are emerging, too. The reported numbers of both diseases increased considerably between the end of March and the end of July. In a couple states, case detection nearly doubled.

The next step will be to accelerate case search throughout the region. State governments in the South-South zone, supported by WHO, continue to train more surveillance officers and community informants on combining COVID-19 and preventable-disease surveillance. Involving communities by educating them and appointing them as public health informants will help ensure that the combined surveillance continues to be a success, says Dr Olubowale Ekundare Famiyesin, WHO Zonal Coordinator of the Niger Delta.

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Early detection of any disease is the goal for health workers in the Delta. “All resources for surveillance at our disposal will be deployed to improve early infectious disease detection and reporting, including COVID-19,” Dr Famiyesin promises.

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Health

COVID-19: Lagos health commissioner, Abayomi tests positive

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The Lagos State Commissioner for Health,  Prof. Akin Abayomi, has tested positive for the coronavirus disease (COVID-19).

Gbenga Omotoso, the state Commissioner for Information and Strategy, disclosed this in  a statement issued on Monday.

The statement also added that Abayomi had close contact with persons feeling unwell who tested positive for COVID-19.

“Subsequent to close contact with persons feeling unwell and testing positive for the COVID-19 infection, the Honorable Commissioner for Health, Prof. Akin Abayomi, has tested positive for the virus.

“Professor Abayomi became aware of his status following the required testing protocol of contact tracing procedures,” the statement partly read.

The commissioner who had no symptoms of the virus, is adhering to the protocol of home-based strategy in the state.

While embarking on self-isolation for the next 14 days, he will still continue to discharge his duties both as the Deputy Incident Commander of the Incident Command System for COVID-19 and as the Commissioner for Health.

Meanwhile, members of the State Executive Council wish him a speedy recovery during the period.

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COVID-19: Imo govt. launches innovative mobile health insurance with support from WHO

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The Governor of Imo State, Mr. Hope Uzodinma last Wednesday launched the innovative Mobile Health Insurance Programme in Owerri.

This mobile health insurance initiative has been designed with support from the World Health Organization (WHO) to achieve seamless coverage of the over 96% population in the informal sector of the State on health insurance while reducing the existing out-of-pocket expenditure of 92%. The mobile platforms in addition, provide automated opportunities for philanthropists to graciously adopt the poor and vulnerable on health insurance.

In his remarks, the  Governor appreciated the leadership role of WHO in the health sector of the state and globally especially in the ongoing fight against COVID-19. He added that the state government depends strongly on the genuine and constructive partnership of the World Health Organization towards achieving Universal Health Coverage (UHC).

Governor Uzodinma added that WHO supported the state, with the design and flag-off of the Health Insurance Scheme, which now culminates in the launch of the use of mobile phone technology to pay for and access Health Insurance, the first of its kind in Africa towards   ensuring that people can get quality health services, where and when they need them, without suffering financial hardship.

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He restated his commitment to repositioning the entire Health Sector in the State, while requesting WHOs renewed partnership in “PHC revitalization, full implementation of the State Health Insurance scheme to provide access to essential Healthcare to Imo citizens at primary, secondary and tertiary levels of care, revamping of our Health Security, Emergency preparedness and response, and overhaul of the drug revolving scheme to eliminate the issue of fake or substandard drugs in our hospitals.”

Speaking at the event, the WHO Nigeria Representative,  Dr Walter Kazadi Mulombo appreciated the government of Imo State for placing the health of her people high on overall agenda of government. While recognizing that the COVID-19 pandemic has further exposed the vulnerabilities of the global health systems, he pledged WHO’s continuous support within the 13 General Program of work and the State Health Strategic Development Plan.

Dr Mulmbo said that WHO recognizes the peculiar needs of each population from others and thus, makes deliberate efforts to fashion out the health system that works for them based on their needs.

He appreciated the level of political commitment to health in the State and expressed confidence that if sustained, the State and WHO will together promote health, keep the world safe, and serve the vulnerable.

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WHO already supported the State with core health financing analytics with development and printing of the State Health Financing Policy and Strategy, operational guidelines of the State Health Insurance Scheme key operational documents for the State Primary Healthcare Development Agency, as well as laptop computers, some of which were presented during the event.

The high point of the event was the conferment of the title of “Oche Ndu 1 (protector and preserver of life) of Imo State” on Dr. Kazadi on behalf of WHO, by the Chairman of Imo State Traditional Rulers, in recognition of all the lives that have been saved through the humanitarian work done by WHO in the State.

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Oyo govt, HACEY Health Initiative set to end female genital mutilation

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Oyo State Government in conjunction with HACEY Health Initiative on Thursday launched a campaign train tagged ” Stop Cut Project ” a project targeted at achieving zero record of female genital mutilation in the state within the next three years.

Oyo State Commissioner for health, Dr. Bashir Bello, while delivering his address at a stakeholders’ roundtable organized by HACEY Health initiative in respect of the Stop Cut Project, held at the Ministry of Health, Secretariat, Ibadan, said it was high time for the public to put aside cultural believes on female organ mutilation considering its effects on victims.

Dr. Bello, maintained that the society needed to be familiar with the consequences of the practice, hence, the government would intensify efforts in educating the populace on hazards attributed to the act.

He attributed the existence of this harmful practice in the society to inability of victims to report the perpetrators to the appropriate quarters for necessary actions, saying that the habit did not enable the perpetrators to pay the price for their actions.

He assured the convener of the project, HACEY health initiative of government support towards realization of set goals.

In his remarks, the Project Director, HACEY Health Initiative , Isiaiah Owolabi, said HACEY was determined to create a network of active people willing to end female genital mutilation in this era.

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Owalabi noted that key stakeholders would be engaged continually and build alliance for the purpose of eradicating the practices especially in core rural areas of the state.

“Our motive is to increase public awareness on female genital mutilation by dishing out risks associated to the practice to the public.

” The period of our intervention is three years, we are doing this in three states, Ekiti, Osun and Oyo. We believe at the end of this arrangement; we will achieve zero record of female genital mutilation in the state.

“We are relying on ministry of health and other relevant ministries and agencies in achieving this.

Similarly, the Oyo State Female Genital Multination Coordinator, Mrs. Baliqis Olawoyin, described the FGM as harmful practice, saying that the havocs emanated from it are usually irreversible.

Mrs. Oluwakemi also noted that the practice is regarded as violation of girls and women rights.
she thereafter called on parents to desist from encouraging or mandating their children to engage in mutilation of female organ for the act to become a thing of the past in Oyo state.

Also speaking, Oyo State Coordinator, National Orientation Agency, Mrs. Dolapo Dosumu, represented by Mr. Moshood Olaleye, said that there is need for government and Non-governmental organisations to sustain the campaign and ensure that they end Female genital Mutilation in Oyo State.

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“I urged all other relevant stakeholders to be actively involved in campaign and effective synergy and networking established for impact”

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